HomeMy WebLinkAbout1242 PLUM TREE RD; ; CB980574; PermitPERMIT APPLICATION
FOR OFFICE USE ONLY S7 L{
PLAN CHECK NO .. __Jf ...... 8~,,...---
EST. VAL. ':)l ~c::90
CITY OF CARLSBAD BUILDING DEPARTMf:NT
2075 Las Palmas Dr., Carlsbad CA 92009
(760) 438-1161
Plan Ck. Deposit ________ _
Validated By __________ _
Date. ______________ _
A~clude Bldg/Suite II
'iJervc-e-,,,
Business Name (at this addressl
Legal Description Phase No. Lot No. Subdivision Nama/Num~LAAI l C Unit No.
Sltrn8J -Sa+s-4 H 1~bt,s Kfh:thilfMl:~teMD
Existing U -,._ P. posed ,µse
l,Vo escd~
# of Bathrooms
Name Address City Stata/Zlp Telephone# Fax#
;3_ · APPLICANT . 'i!:tcontractor O Agent for Contractor • 0 Owner~ ·o Agentfot Owner
Name Address City State/Zip Telephone#
S. CONTRACTOR. COMPANY NAME .·--.::,-~ P'j-~~~::·-:-:'.'"":"'T'-"'.-~~::c-·-:,"".:"'-:."'·cr;~F':'::"., .•.. -•· · · "
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, Improve, demolish or repair any structure, prior to Its
issuance, also requires the applicant for such permit to file a signed statement that he Is licensed pursuant to the provisions of the Contractor's License Law
(Chapter 9, commending with Section-7000 of Division 3 of the Business and Prolnsions Code! or that he Is exempt therefrom, and the basis for the alleged
exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the appllcan to iviJ_penalty of not more than five hundred dollars ($50011. --•-..a-Al,/;,L ~ r , e,
Cit State/Zip Te eph ne I
State License I S-7 7fr'J13 License Class fl-{ City Business License I / :Z O 5'?,,£1
Designer Nam;,l.awe.J.L. DvKZ-e."ft:
State License I 9'9'Q/ £3/f/G,
Address { 7 'ltJTr"V ¼ City OCH, Stete/ZIPq' ~Telephone 7 6()-'1 :! /-5"~7 8"'
8. WORKERS' COMPENSATION ..
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
0 I have and will maintain a certificate of consent to self-Insure for workers' compensation ■s provided by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
'¢-, I have and will maintain workers' compensation, es required by Section 3700 of the Labor Code, for the performance of the work for which this permit Is
issued. My worker's compensation insurance carrier and policy number are:
Insurance Company 5'rd:7-e Fvvb Policy No./'{9.-S-lz,.'3 2-r1 Expiration Date I I-I -r?
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESSI
0 CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ any person In any manner so as
to become subject to the Workers' Compensation Laws of California.
WARNING: Fallure to secure worlle,1' compen■■tlon coverage 11 '"11awful, end lhell aubject en employer to criminal peneltlea end cMI fine, up to one hundred
thousand dollar1 $100, 01, In addition to co1t of compensation, damage1 u provided for In Section 3706 of the Labor code, lnt-•t end attorney'■ fees.
SIGNATURE:~'llh,.o...o::~4.q~~c:J'l.g_~~:-__ ____________ DATE :2 -& 9:%'
7. OWN . .. ...... i "' ~ ....... ., • "·. ·• ·.-: : ·:..~~~;~:·~7,:::""\-~::r ,!"",':'~,~~;~'r.-;:•Y:r--its••Pf 1··•.Y:•~ffT71 :~":': ... -:~· .·~_·, '
I hereby affirm that I em exempt from the Contractor's License L1w for the following reason:
O I, as owner of the property or my employees with wages es their sole compensation, will do the work and the structure Is not Intended or offered for aale
(Sec. 7044, Business 1nd Professions Code: The Contractor's License Law does not apply to an owner of property who build• or lmprov■s thereon, and who doas
such work himself or through his own employe■s, provided that such Improvements are not Intended or offered for 111■. If, however, the building or Improvement ls
sold within one ye■r of completion, the owner-builder will have the burden of proving that he dld not bulld or Improve for the purpose of ■■lel.
O I, as owner of the property, am exclusively contracting with licensed contractor■ to construct the project IS■c. 7044, B111ln■H and Profeaslona Code: The
Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor Isl licensed
pursuant to the Contractor's License Lewi,
0 I am exempt under Section ______ Business and Professions Code for this re11on:
1 . I personally plan to provide the major labor and materials for construction of the proposed property Improvement. 0 YES ONO
2, I (have / have not) signed an application for • building permit for the proposed work.
3. I have contracted with the following person (firml to provide the proposed construction flnclude name I address / phone number / contractors license numbarl:
4. I plan .to provide portions of the work, but I have hired the following person to coordinate, supervlae and provide the major work (Include name I address / phone number/ contractors license numberl: ______________________________________________ _
5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work Indicated flnclude name/ address / phone number I type
of work!: ·
PROPERTY OWNER SIGNATURE ______________________ _ DATE _________ _
1C0MPLETE THIS SECTION FOR NON-RESIDENIW. iUli.DiNO PERMitS otJi.y,l;V:1~'t-~"."'!~:ri~,r:T"l'f~~'!.~~.':':'-1,;,:~;:1"":"'!l~'~;n•~··· .... -••"T,-:'.,.,-,·-·~~--
1s the applicant or future building occupant required to 1ubmlt • business plan, acutely hazardoUI material■ registr■tiori form or risk management and prevention
program under Sections 25505, 25533 or 25534 of the Presley-Tanner H■z■rdo111 Substance Account Act7 0 YES O NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control dlstri_ct or air quality management distrlct7 0 YES O NO
Is the facility to be constructed within 1,000 feet of the outer boundary of• school site? 0 YES O NO
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE
REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
!8, ... CONSTRUCTION LENDING AGENCY ",'' .,,, •""····••·• ~-or;·, :;'-:";T?:::-e::f'.~:''""~..,o-m, :~,•·-,, .. ..,,.,,.,, .... ,c,.,·,:-,-·,•,-• "r.·•-r•· , .. ,,,_ .. , · '·:•
I hereby affirm that there is • construction lending agency for the performance of the work for which this permit Is i11ued (Sec. 3097(i) Civil Code).
LENDER'S NAME ______________ _ LENDER'S ADDRESS. _______________________ _
[9. APPLICANT CERTIFICATION ,.,---·
I certify that I have read the application and state that the above Information ls correct and that the Information on the plans is accurate. I agree to comply with 111
City ordinances and State laws relating to building construction. I hereby authorize representatives of the Cltt of Carlsbad to enter upon the above mentioned
property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES,
JUDGMENTS, COSTS ANO EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
OSHA: An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height.
EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shall expire by limitation and become null and void ii the building or
work authorized by such permit is not commenced within 365 days from the date of such permit or If the building or work authorized by such permit is suspended
or abandoned at any time after the work is menced f period of days (Section 106.4.4 Uniform Building Code).
/\PPI.ICANT'S SIGNATURE --,,.j6"'~::::::_-'7q,_..CJ,,.~~~~~r.d.,~::::::________ DATE C:-..e,6. 2 , /y~ 7 PINK: Finance
PERMIT# CB980574
DESCRIPTION: 250 SF DECK WITH
EXCHANGE WINDOWS
TYPE: PATIO
CITY OF CARLSBAD
INSPECTION REQUEST
FOR 07/17/98
ELECTRIC
FOR DOORS
RD STE:
INSPECTOR AREA PD
PLANCK# CB980574
OCC GRP
CONSTR. TYPE VN
LOT: JOB ADDRESS: 1242 PLUM TREE
APPLICANT: MACDUFFIE, JERRY
CONTRACTOR:
PHONE: 760 414-1363
OWNER:
REMARKS: B/JERRY/414-1363
SPECIAL INSTRUCT:
TOTAL TIME:
CD LVL DESCRIPTION
:~~::: /,l' .~ &
INSPECTol.4~7~~.,._.,--,9~~~~-=--=-"---==~-
ACT COMMENTS
_1_9 __ s_T _F_i_n_a_1_s_t_r_u_c_t_u_r_a_1 _______ t---------------
------------------
***** INSPECTION HISTORY *****
DATE DESCRIPTION ACT INSP COMMENTS
070998 Final structural co PD
070898 Final Structural NS PD
070198 Final Structural co PD ON CARD
060298 Frame/Steel/Bolting/Welding co PD ON CARD
060198 Frame/Steel/Bolting/Welding NS PD
052998 Frame/Steel/Bolting/Welding co PD NO PLAN
050598 Ftg/Foundation/Piers AP PD SPIRAL STAIR
050198 Ftg/Foundation/Piers co PD
031298 Ftg/Foundation/Piers AP PD